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Hello,

I have bipolar II diagnosis and I'm trying Lamictal 100mg (lamotrigine) and I don't feel any antidepressant effect.  I would like to know what dose do you take and what dose do you consider to be a range where it mostly works for bipolar depression.  My pdoc has told me that for bipolar depression the range is usually between 100 and 200mg.  I have read people that takes even up to 900mg!!

How much time should I stay on 100mg before I realize that I need to increase the dose?

Please share with me your experiences with Lamictal.

Thanks!

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Dx: Bipolar II, OCD, Insomnia.

Current Meds: Paxil 40mg, Mirtazapine 30mg, Klonopin 4mg, Lyrica 75mg TID, Amisulpride 50mg, Lamictal 100mg

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Welcome to CB!

I am on 600 mg/day of lamictal. YMMV though. 

Everyone is individual in the amount they need/day to get to the point where it works for them, so it is hard to say what would be the best dose for you. 

2 hours ago, enriquegm82 said:

How much time should I stay on 100mg before I realize that I need to increase the dose?

I think this would a great question to ask your psychiatrist (pdoc) about (actually ... are you seeing a pdoc or another DR prescribing the lamictal for you?)

Your DR would know this and the titration schedule for you.  It depends where you on the titration schedule for lamictal to say how long you should be on 100 mg for. 

It is a slow titration up and you might feel worse before getting better until you reach a level you feel ok at.

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7 hours ago, enriquegm82 said:

Hello,

I have bipolar II diagnosis and I'm trying Lamictal 100mg (lamotrigine) and I don't feel any antidepressant effect.  I would like to know what dose do you take and what dose do you consider to be a range where it mostly works for bipolar depression.  My pdoc has told me that for bipolar depression the range is usually between 100 and 200mg.  I have read people that takes even up to 900mg!!

How much time should I stay on 100mg before I realize that I need to increase the dose?

Please share with me your experiences with Lamictal.

Hey enriquegm82 - Welcome to CB! I'm on Lamictal again (was on it years ago) and now starting to wonder the same thing - how do you find the right dose & how long to wait? I don't experience mania either, only severe depression (with some anxiety). I have tried many many antidepressants and meds that were not helpful or made me worse.

I've just gone up to 125mg (after being on 100mg for 6 weeks) It's bizarre. I noticed positive mood balancing effects at 75mg and have continued the titration, but it also seems that many days, it's not doing anything, like a sugar pill...I think it is helping to "even out" my intense moods, however, it is not doing enough for my depression. I'm really discouraged about it. Previously, I had gone up to 400mg, but when I reached 300mg on Lamictal I had side effects (slight balance issues, cognition/memory problems, issues with word finding, possible hair loss)

I've heard (from my pdocs) that there is little benefit to going above 300mg (however, many people here feel otherwise). So I don't know what to do. I will continue a more slow titration until at least 200mg and reassess. I've heard that you need to be on Lamictal for a long time to see if it will benefit you, mood-lifting effects are very subtle.

Edited by cloudmonger
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I'll also add: Lamictal is not known to be a potent, "fast-acting" type antidepressant. Neither activating nor sedating, It works well as a mood stabilizer with a lower side effect profile (can be more tolerable) than others in it's class (apart from the possible rash thing)...I've also heard it's better for bipolar Depression (versus Mania - Lithium is the preferred med for more manic bipolar-types) From what my pdoc says. YMMV.

Edited by cloudmonger
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I'm on 200mg and don't really get much of an effect from it. My pdoc is focusing on my APs at the moment though so once that's stabilised we'll go back to the lamicatal and try and find a potent dose. 100mg is quite low, I think it would be well worth speaking to your pdoc about it and seeing what they say.

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2 hours ago, cloudmonger said:

I've heard (from my pdocs) that there is little benefit to going above 300mg

FWIW ... IME there is definitely a benefit to going over 300 mg/day.  If I took only 300 mg every day, it would not be effective and I would become symptomatic again.

I know all pdocs think differently, but my pdoc thinks going over 300 mg helps some people, which is why he prescribes a higher dose (than 300 mg/d) to some of his patients.

Also, I take the ODT kind, which is the disintegrating kind under your tongue, which acts instantly (meaning seconds).

1 hour ago, The Hitcher said:

100mg is quite low, I think it would be well worth speaking to your pdoc about it and seeing what they say.

I agree.

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I am on 250mg, 150mg in the morning and 100mg at night. Up until recently I was taking 300mg but I started on valproate which apparently increases the level of lamictal so my pdoc reduced it, firstly to 200mg but that was horrible so he put me on 250mg and that was OK. I find it to be a very calming medication when it has reached an acceptable dose and remain on that dose for 4-6 weeks. It is a slow process but it is worth it

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Hello,

As I see 100mg is quite a low dose. I should target 200mg/day minimum and today I have appointment with my pdoc so I will discuss with him about that.

I see that Lamictal is not a potent fast acting antidepressant, could you please share with me what kind of antidepressant benefit do you have.

Thanks!

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24 minutes ago, enriquegm82 said:

I see that Lamictal is not a potent fast acting antidepressant, could you please share with me what kind of antidepressant benefit do you have.

Thanks!

It's most effective in stabilizing your mood, meaning ideally, your lows won't be so low and if you get any mania (or hypomania/agitation) it should lessen that as well. It keeps me even, level-headed and less emotional/upset about things (without numbing me out and muting all emotions) I still have some ups & downs, but these are more normal & situation-appropriate feelings/reactions to things. So as a result, the depression is much much less severe and the lamictal can increase the time between episodes (if your depression is more cyclical & episodic) Does this make sense?

Edited by cloudmonger
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When I first titrated up on lamictal (I forget the dosage 100 or 200mg) it scared me. I had felt meh for so long to feel good made me worry I would feel too good. It did help for awhile.

I agree with your idea of asking to increase to 200mg

(I thought the max for bipolar was usually 400mg but I could be wrong)

It is not a strong anti-depressant. It is more of a mood stabilizer with a mild anti-depressant effect.

I haven't tried it but latuda is supposed to help with bipolar depression, too. (It is an aap). I am not suggesting switching meds, just something you could keep in mind.

I am now on wellbutrin and lexapro also. The lexapro is more for anxiety, but they are both antidepressants. Many docs don't like to use antidpressants long term with mood disorders. These just happen to work for me.

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22 minutes ago, cloudmonger said:

It's most effective in stabilizing your mood, meaning ideally, your lows won't be so low and if you get any mania (or hypomania/agitation) it should lessen that as well. It keeps me even, level-headed and less emotional/upset about things (without numbing me out and muting all emotions) I still have some ups & downs, but these are more normal & situation-appropriate feelings/reactions to things. So as a result, the depression is much much less severe and the lamictal can increase the time between episodes (if your depression is more cyclical & episodic) Does this make sense?

Hi cloudmonger!

Thanks for your response.

Yes, it makes sense.  It disappoints me a little because I was expecting Lamictal to be my antidepressant since Paroxetine is not helping much with depression, I mainly take it for my OCD.  Perhaps I should consider switch to Lexapro or Prozac to help Lamictal with depression.

25 minutes ago, confused said:

I agree with your idea of asking to increase to 200mg

It is not a strong anti-depressant. It is more of a mood stabilizer with a mild anti-depressant effect.

I haven't tried it but latuda is supposed to help with bipolar depression, too. (It is an aap). I am not suggesting switching meds, just something you could keep in mind.

Hi confused!

Thanks for your reply.

Latuda is an interesting drug, however I will keep in mind because right now it's very expensive and I can't afford it.

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I definitely consider 100mg lamotrigine is very low dose. I see that most of people find benefit from 175mg - 300mg.  In the meanwhile I feel anxiety and little exacerbation of OCD. Hope my pdoc increase my dose.

Do you think 150mg could work? I know that YMMV though.

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Just now, Dphxa said:

I tried Lamictal a few years back.  I think I made it up to 50 or 60mg and got the insomnia.  It gave me some weird uncomfortable dreams on the way up until I was unable to sleep at all.

Did you try it at nights? Did you try it at mornings? Many people report that Lamictal triggered mania in the way that they were unable to sleep and they had to continue until reach the target dose, and the insomnia subsided. 

What are you taking right now?

 

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I was on 75mg daily for a week until today where I'd have enough, been depressed for the last few days and I just know that it only gets worse until they get increased.. usually it's increased every 2 weeks but my doctor has increased me to 100mg daily and will be increasing weekly.. they work for a week and I'm extremely depressed for the second which I can't risk anymore.. last time I was on the I got to 100mg and was okay for the 2 weeks so my doctor didn't increase and 2 days later I overdosed. how will I know that I'm at the therapeutic dose? is it okay to up them weekly?

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3 minutes ago, dragonfly23 said:

I started slow, very slow.  Reached 150 and stayed there a bit, then 200 and then 250 and now 325.   The titration was very hard but once I got to 150 I started feeling better.  However, lamictal is only part of my cocktail.  Listed below

It's funny that you list "Alcohol" as a prior "med" in your signature. :D

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